Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV).

1. Presented by
Ved prakash panda
M.Pharm (pharmacology)

2.  Introduction
 Epidemiology
 Aetiology
 Pathophysiology
 Clinical menifestation
 Diagnosis
 Treatment

3.  Human immunodeficiency virus(HIV) is class
of retrovirus that cause HIV infection &
overtime immune system begins to fall
causing immunodeficiency, leading to AIDS.
 Two types of HIV: HIV 1 & HIV 2
 Epidemiology:
 mostly prominent in man then in female &
the majority of HIV have acquired infection in
country of high prevalance like UK & US.

4.  AETIOLOGY:
 Predominant routes of transmission is sexual
intercourse.
 Sharing of unsterilised needles or syringes
 Transfusion of blood products.
 Transfer from mother to child through
placenta, during labour or breast feeding.

5.  Its surface glycoproteins molecules (GP120) has a
strong affinity for the CD4 receptor found in T-
helper cell macrophase & dendritic cells.
 Its also binds to co- receptor such as CCR-5 or
CXCR-4 and thus causing membrane fusion.
 After penetrating in to the host cell, the virus
sheds its outercoat & release its genetic material.
 Using the reverse transcriptase enzyme, the viral
RNA is converted to DNA using nucleosides.

8.  The viral DNA is then integrated into the host
genome in the cell nucleus, where it
undergoes transcription & translation,
enabling the production of new viral proteins.
 New virus particles are then assembled & bud
out of the host cell, finally maturing in to
infectious virions under the influence of the
protease enzymes.
 Overtime a chronic infection ensures, cell
possessing CD4 receptors, particularly the T-
helper cell are depleted from the body.

9.  Clinical manifestation:
 As there is failure of immune system, Infection
will occour more frequently ex. Salmonella,
herpes, mycbacterium tuberculosis, cytomegalo
virus.
 Malignancies occours in immuno component
population, ex. non hodgkin’s lymphoma
 Chronic immune activation including premature
neurocognitive dysfunction, bone mineral density
loss.
 In additional 70% of individual develop a flu like
illness.

10.  DIAGNOSIS:
 Antibody test:
 Initial diagnosis of HIV infection is made by
detection of antibodies against HIV, with in 3-4
weeks of infection.
 CD4 COUNT:
 The level of immunosuppresson is most easily
estimated by monitoring a patient CD4 count.
this measure the No. of CD4 positive T cell in a
sampl of peripheral bloods.
 The normal range can be between 500-
1500cells/mm3.

11.  Viral load:
 The measurement of plasma HIV -RNA(viral load)
estimates the amount of circulation in the blood.
 DRUG TREATMENT:
 A combination of 3 anti retroviral agents selected
on the basis of treatment history,should be
prescribed.
 The majority of individuals are currently
commenced on combination of 2 NRTI’S & 1
NNRTI’S OR 2NTRI’S & 1 PI.

12. ANTI- RETROVIRAL AGENTS:
 Nucleoside reverse transcriptase
inhibitors(NRTIS):
 Zidovudine, lamivudine,stavudine
 Non-nucleoside reverse transcriptase
inhibitors(NNRTIS)
 Efuvirenz, nevirapine
 Protease inhibitors:
 Itonavir,indonavir
 Integrase inhibitor:
 raltegravir